Travel Insurance
BENEFITS:
• Maximum Benefits – $5,000,000 CAD
• Emergency hospital – semi-private room in a hospital.
• Ambulance Transportation – local licensed ground ambulance service. Fire rescue expenses are also covered if a fire rescue team is dispatched in response to your emergency.
• Emergency Air Transportation* – the cost for an economy class airfare, stretcher or air ambulance evacuation to Canada or between medical facilities.
• Physician’s Fees
• Diagnostic Services – laboratory tests and X-rays.
• Prescription Drugs – 30-day supply per prescription.
• Medical Appliances – the rental or purchase (whichever is less) of splints, casts, crutches, canes, slings, trusses, orthopedic corsets or for the rental of walkers or wheel chairs or other medical appliances.
• Private Duty Nursing – when ordered in writing by the attending physician.
• Follow up Visit*– if medically necessary to the initial emergency.
• Accidental Dental – up to $2,500 USD for an accidental blow to the face requiring the repair or replacement of sound natural teeth or permanently attached artificial teeth, including crowns, bridges and dental implants.
• Emergency Dental – up to $400 USD for dental emergencies other than Accidental Dental.
• Professional Medical Services*– up to $500 USD per type of medical specialty for a chiropractor, chiropodist, paramedical, optometrist, osteopath, physiotherapist or podiatrist when referred by a physician.
• Hospital allowance – covers hospital charges, such as but not limited to, TV rental, telephone charges and parking, limited to $50 USD per day up to $250 USD.
• Childcare – up to $500 USD per day to a maximum of $5,000 USD when the insured person is confined to a hospital.
• Emergency Transportation to Insured Person Bedside* if the attending physician warrants that it is required – One round trip economy airfare or ground transportation and $150 USD per day up to $1,500 USD for accommodation, meals, telephone calls, internet charges, taxi or bus fare for a family member or friend of the insured person.
• Return of Deceased (Repatriation of remains) *- the preparation and return of the body and transportation to the home province/territory OR up to $5,000 USD for burial at the place of death or cremation.
This benefit includes the transportation of one immediate family member to identify the body (when it is necessary) and up to $150 USD per day to a maximum of $1,500 USD for meals and commercial accommodation.
• Return of Traveling, Companion, Spouse, child/grandchild, Dependent Child(ren)**– up to $1,500 USD for a one-way economy airfare (and escort if required) to return for one travelling companion back to your home province/territory in case of your air ambulance evacuation or death.
• Return of Excess Baggage**– up to $250 US to return your baggage in case of your air ambulance evacuation or death.
• Return of Vehicle ***– up to $3,000 USD to return your own or rent vehicle if you are incapable as a result of an emergency.
• Return of Pets**– up to $250 USD to return your pet(s) in case of your air ambulance evacuation or death.
• Return to your Destination**– the cost of a one-way economy airfare to return you to the place of your air ambulance evacuation to continue your trip as originally booked.
• Flight Delay (requires registration) – When your registered flight is delayed by 2 hours or more:
– Free access for all insured travellers to an airport lounge through the direct reservation service;
– A cash payment of $40 CAD per insured traveller if no airport lounge is available for any reason.
* Benefit is ONLY payable when pre-approved and arranged by claims assistance “LS”.
** This benefit is only applicable in coordination with the Emergency Air Transportation or the Return of Deceased benefit.
***Must be pre-approved by the claims assistance “LS” as the maximum benefit payable is limited to the amount it would cost the Company and “LS” to return Your Vehicle by a commercial agency.
ELIGIBILITY:
You must meet the following eligibility requirements on the departure date of each trip in order to be eligible for coverage.
Coverage is NOT AVAILABLE to any individual who:
1. is travelling against the advice of a Physician; or
2. has a life expectancy of 6 months or less;
3. requires assistance with any activities of daily living (eating, dressing, personal hygiene).
WAITING PERIOD:
48-hour period of time following the policy effective date if the policy was purchased after departure and there was a gap in coverage that any claim related to sickness would not be covered.
PRE-EXISTING CONDITIONS:
Stability period:
a. Stability must be met prior to the departure date of your trip. For individuals 59 years or less, it is 45 days with the option to reduce it to 7 days.
b. Stability must be met prior to the departure date of your trip. For individuals 60 years or older, it is 365 days with the option to reduce to 180 days, 90 days, 7 days.
Stable – Medical Condition (other than a Minor Ailment) for which all the following statements are true:
1. There has not been a new diagnosis, any new treatment prescribed or recommended, or change(s) to existing treatment (including a stoppage in treatment), and
2. There has not been any change to any existing prescribed medication (including an increase, decrease, or stoppage to prescribed dosage), or any recommendation or starting of a new prescription medication (Exceptions the routine adjustment of Coumadin, Warfarin or insulin and the change from a brand name medication to a generic brand medication of the same dosage); and
3. There has not been any new, more frequent or more severe symptoms, and
4. There has not been any hospitalization or referral to a specialist, and
5. There has not been any medical exam, investigative testing or test results showing deterioration; and
6. There has not been any treatment recommended, planned or not yet completed, nor any outstanding test results.
All of the above conditions must be met for a medical condition to be considered Stable.
Minor Ailment – a condition that does not require the following:
a. Hospitalization or surgical intervention.
b. Referral to a specialist.
c. Treatment for a period greater than 32 days.
d. More than one follow-up visit.
e. Treatment ending at least 30 days prior to departure date.
EXTENSIONS:
Your coverage can be extended as long as:
– You do not have a claim on your file, and
– You call in prior to the expiry date of your insurance.
– You do not exceed the maximum number of days allowed by the plan.
Review by the administrator is required for all extensions. The underwriter reserves the right to deny the request for an extension at any time.
Automatic Extension of Coverage
Your coverage will be automatically extended without any additional premium for up to 5 days, upon notifying the Assistance Center, if your scheduled return date to your home province/territory is delayed beyond the expiry date of your insurance due to the following reasons:
– The delayed arrival or departure of a common carrier aboard which you are travelling causes you to miss your scheduled return date to your home province/territory.
– The vehicle in which you are travelling is involved in an accident or mechanical breakdown that prevents you from returning to your home province/territory on or before your expiry date of this insurance.
– If driving, a delay due to inclement weather preventing You from returning to your home province/territory on or before your expiry date of this insurance provided the return journey commences prior to the expiry date of this insurance.
– You or your travel companion’s return is delayed beyond the expiry date of this insurance as a direct result of sickness or injury for which you or your travel companion are not deemed medically stable to return to your home province/territory in the opinion of the Assistance Center.
NOTE: If you or your travel companion must remain hospitalized beyond the date coverage terminates for your trip for medical treatment, coverage will remain in force for as long as you or your traveling companion remain confined to a hospital, plus up to an additional 5 days after discharge from the hospital. All coverage will never be extended more than 365 days from your departure date of your trip.
REFUNDS:
NOTICE OF RIGHT TO EXAMINE THE POLICY FOR THE MEDICAL EMERGENCY PROTECTION:
The Insured Person(s) have ten (10) days, from the day you receive the policy, to inspect it and verify the accuracy of your declaration and application. This policy contains limitations and exclusions. Please read it carefully and contact your representative if needed before leaving. A refund would be provided if no travel has taken place.
A refund of the premium paid may be requested under the following circumstances:
– If your entire trip is cancelled before your policy effective date: For a refund*, you may request a refund by notifying your broker in writing before your policy effective date as shown on your confirmation of benefits, otherwise if notification is made after your policy effective date, your refund will be calculated based on the remaining days of coverage from the date of notification. Proof of non-departure is required.
– If, after your departure date, you return to your home province/territory (or Canada on your Multi Trip Annual Plan when associated with a corresponding top up policy) before your scheduled return date: For a partial refund, you may request a refund of premium* for the remaining days of coverage, provided no claim has been reported or initiated. Your refund will be calculated based on the remaining number of days of coverage. Refunds of under $20 will not be made. Your request must be made in writing to your broker with satisfactory proof (e.g. receipt in home province/territory, airline boarding pass or customs/immigration stamps) of your return date to your home province/ territory (or Canada on your Multi Trip Annual Plan when associated with a corresponding top up policy), within 60 days of your return date.
– For Multi-Trip Annual Plans a refund of premium is only available by notifying your broker in writing before your policy effective date as shown on your confirmation of benefits. The premium is non-refundable as of the policy effective date as shown on your confirmation of benefits.
NOTE: No refund is available after your departure date for any reason than one listed above. Example such as but not limited to receiving health coverages at destination would not be a reason for a partial refund.
*Administration fees may apply for the processing of any modification of premiums.
CLAIMS:
IN THE EVENT OF AN EMERGENCY CALL THE ASSISTANCE CENTRE IMMEDIATELY 1-833-268-0553 toll-free from Canada or the U.S. or 1-514-657-8656 collect from anywhere else.
Please note that if you do not call the Assistance Centre in an emergency and prior to treatment, you will have to pay 30% of the eligible medical expenses AwayCare would normally pay under this policy. If it is medically impossible for you to call, please have someone call on your behalf.
The Assistance Centre will verify and explain your coverage to you; refer you to a medical provider; arrange to have your covered expenses billed directly to AwayCare where possible; and monitor your medical condition.
Please mail all original receipts, bills, and invoices to:
Penfield Care, Inc
310-260 Hearst Way
Ottawa, Ontario, Canada K2L 3H1
Your claim must be sent to AwayCare within 90 days of your loss. Ensure you keep a copy of your receipts, bills, and invoices for your records.
To determine which documents are needed for each type of claim, refer to the insurance plan under which you are filing a claim.
Cash register coupons (stubs) will not be accepted for reimbursement.
Any fees for the completion of medical certificates or claims forms are not covered by the Insurer.
Failure to complete the required claim & authorization form in full might invalidate your claim.
All claim forms are available online at https://awaycare.ca/en/claim-forms/ or by calling 1-833-268-0552.
EXCLUSIONS:
Benefits are not payable under this policy if losses sustained or expenses incurred are the direct or indirect result of any of the following, for:
1. If You /Your Pre- Existing conditions do not meet the required Stability outlined on Your confirmation of benefits
a. Stability is calculated at the departure date of your trip. For individuals 59 years or less, it is 45 days with the option to reduce it to 7 days.
b. Stability is calculated at the departure date of your trip. For individuals 60 years or older, it is 365 days with the option to reduce to 180 days, 90 days, 7 days.
2. If You are traveling for the purpose of seeking medical Treatment.
3. Any Medical Condition or Symptoms for which it is reasonable to believe or expect that Treatment will be received during the trip.
4. Consumption or use of illegal or controlled drugs (based on the laws at location of claim).
5. Any Medical Condition, including Symptoms of withdrawal, arising from Your chronic use of alcohol, drugs or other intoxicants.
6. Any Medical Condition arising during Your Trip from the abuse of alcohol, drugs or other intoxicants. Alcohol abuse is defined as having a blood alcohol level in excess of eighty (80) milligrams per one hundred (100) milliliters of blood.
7. Any medical service, procedure or Treatment not authorized by the claims assistance company “LS”.
8. Any elective Treatment, procedures, or surgeries.
9. Treatment received in Your Home Province/territory of residence.
10. Loss, theft, or breakage of prescription glasses, dentures, hearing aids, prosthetic devices or contact lenses.
11. Any medical Treatment, Recurrence or complications related directly or indirectly to a Sickness or Injury which was diagnosed or for which symptoms first occurred, or medical Treatment was received after the Departure Date but prior to the Policy Effective Date of this Insurance.
12. Any expenses incurred as a result of Sickness that originated or was symptomatic during the Benefit Waiting Period. This exclusion does not apply when this policy is purchased to top-up any other insurance plan.
13. Any condition that You are on a waiting list or registered for treatment or awaiting a diagnosis for in Canada.
14. Expenses incurred once the Emergency ends and in the opinion of Medical Director of the Assistance, You are able to travel to Your home province/territory of residence for any further treatment relating to the sickness or Accident that led to the Emergency (other than specified under the Follow-up Visit Benefit).
15. Any eligible medical and related expenses in excess of $25,000 if You are not covered by Government Health Insurance Plan (GHIP) at the time of Your claim.
16. Emergency Sickness or Injury incurred if You choose to travel to a destination after a formal written travel advisory and/or travel warning has been issued by Global Affairs Canada or Public Health Agency of Canada (PHAC) recommending that You avoid all or non-essential travel to that destination during Your Trip. This exclusion applies if the advisory/warning is issued before the date you leave for Your Trip and the expenses are directly or indirectly caused by the reason for the travel advisory/warning. This exclusion is nullified should the reason for your trip be directly related to an essential service/act deemed by the Destination Government or the Government of Canada.
17. Your participation in and/or voluntary exposure to acts of terrorism or war.
18. Your suicide or attempt to inflict self-injury.
19. Any injury resulted by Your commission or attempted commission of a crime or offence. This is based on the law in the location of the claim.
20. Pre-natal care, voluntary termination of pregnancy.
21. Complications related to pregnancy or delivery of child within the nine weeks immediately before the expected delivery date (including the expected delivery date) or the nine weeks after the actual delivery date (including the actual delivery date).
22. Medical Treatment following the unexpected birth for the newborn.
23. Psychological disorders, emotional or mental disorders. Acute psychosis is not excluded unless drug, alcohol or medication induced.
24. Emergency Air transportation unless pre-approved by claims Assistance Company “LS”.
25. Expenses incurred as a result of failure to follow the Physician’s or Emergency Assistance Medical Director advice, Treatment or recommended Treatment.
26. Any eligible expenses in excess of $200,000 when related to an epidemic or pandemic identified by the World Health Organization at the time of Departure. This exclusion is nullified in relation to COVID19 and would be covered up to policy maximum.
27. Any eligible expenses incurred as a result of Sickness while under a mandatory or suggested Quarantine upon arrival. This exclusion applies if the expenses are directly or indirectly related to the reason for Quarantine.
28. Any eligible expenses incurred due to requirements for entry or re-entry on your trip including but not limited to mandatory testing.
29. Any Treatment that could reasonably be delayed until the Insured Person returns to his/her province of residence even if the perception is that the care may be of less accessibility and quality in the province of residence.
30. If the Medical Assistance decides that You should transfer to another facility or the Emergency Assistance Medical Director determines that You can return to Your province of residence for Treatment (by the most appropriate transport option), and You (or a member of Your family) choose not to, benefits will not be paid for this Treatment and any further medical Treatment. The contract will be terminated, and the Insurer will be relieved of any further liability.
31. Any Accident or Medical Condition sustained while participating in: – professional or competitive sports, any race or speed contest, gliding, hang-gliding, rock climbing, mountain-climbing which involves the ascent or descent of a mountain requiring the use of specialized equipment including but not limited to crampons, pick-axes, anchors, bolts, carabiners and lead or top-rope anchoring equipment, mountaineering, spelunking, rodeo, rafting, acrobatic skiing or snowboarding (including kitesurf), bungee jumping, parachuting or other aerial activities, or underwater activities using a breathing apparatus (except snorkeling); any activities involving the Insured not following security requirements, not obeying warning signs or being in restricted zones.
By Paying an additional premium, You can choose to remove Exclusion #31. Please refer to Your Travel Insurance Confirmation to find out if You have chosen that option.
32. Any loss resulting from an Accident or Medical Condition sustained while onboard a commercial vehicle, other than as a passenger, or sustained while onboard an aircraft other than as a fare paying passenger on a flight operated by a common carrier.
33. Any organ retrieval, donation and/or transplant and blood donation.
34. Consequential loss of any kind, including loss of enjoyment and financial loss not otherwise specifically covered under this policy.
35. Fraud or attempted fraud, concealment or misrepresentation of any material fact affecting this insurance or in connection with the making of any claim.
– Family plans are available for individuals that are 59 or under with one Spouse or common law Spouse (also 59 or under) and Dependents Child(ren).
– Dependent Child(ren)/grandchildren – all unmarried children residing in your household up to the age of 18, or up to the age of 28 if enrolled full-time at an educational institution. Dependent child also includes any individual at any age that has a mental or physical disability diagnosed.
IMPORTANT NOTE: The product-related information on this website is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please see the policy booklet at the download section below. Please read and understand your policy before you travel.
